Our facility is trying to develop a system for adequate MDS documentation. We have tried posting diagnosis driven cheat sheets (document on at least 2 of these items/shift) posted on the chart and a...
dian57 replied to Nurse Ratched's topic in Geriatric, LTC
First, I am NOT saying the facility was not at fault in this case. But a word of caution must be spoken. We (the public, not just nurses) really need to keep in mind that this story was printed in the...
dian57 replied to Inquisitive one's topic in Geriatric, LTC
Since we initiated the supervised activity program the only falls we've had are rolls out of bed (onto bedside mattresses) and late night wandering out into the bathroom (although staff was alerted by...
dian57 replied to Inquisitive one's topic in Geriatric, LTC
We have the same issue (doesn't everyone in LTC?). We instituted 1/2 hour activity "bursts," as we've determined our population doesn't have much more than 30 minutes worth of attention span to devote...
First, let me apologize if I repeat something already posted. I have not read all the previous posts. Palliative Care is a relatively new concept in our country; a country that is accustomed to fixing...
dian57 replied to RN06-NP09's topic in Nursing Humor
As far as visitors and excessive use of callbells and visits to the nurses station with questions: I've often considered posting a sign that says: If you have run out of conversation with your loved...
I remember another student nurse experience and hope this doesn't offend anyone here. I was all of 19, a student LPN. My instructor, a student friend and I stood at the bedside of a 30ish man as I...
There was a little boy down the street and his parents wanted to name him Harley with Davidson as his middle name. They settled on Dallas. The little brother was Austin. Were they from Texas? Nope,...
I had the hardest time with Maternal/Child nursing. And, like HarleyGirl, I can tell you why--I had absolutely NO INTEREST in Maternal/Child nursing. As one of the oldest students in the class, I got...
dian57 replied to Marie_LPN, RN's topic in LPN to RN
I was an LPN for 17 years. I had this one nutty RN supervisor for awhile who relieved an even nuttier day supervisor on my unit (LTC). One evening the other LPN on the unit looked at me and said,...
dian57 replied to RN06-NP09's topic in Nursing Humor
JBudd reminded me of a silly thing *I* did on the job recently. The DOH was in for the annual survey. I was 6 weeks into my new position as DON and feeling more than a little stressed with their...
That's where the Medical Director comes in. It's up to the M.D. to rein in the rouge docs who think their time is worth more than anyone elses. If a doctor ever hung up on one of my nurses, the next...
I think a "Continue Home Meds" order can be dangerous and leave the doc open to problems with misunderstandings, especially in my geriatric setting. Maybe it's okay for younger hospital patients with...
I agree with Bird2. As a floor nurse, duplicate documentation made me crazy. As a Clinical Care Coordinator I recognized the danger of duplication--the more places the same information was written,...
The only time I've ever used controlled isolation with a resident was a lady with a stroke that left her with incessant chanting. With assessment and observation, we saw that her chanting escalated to...
Working in a nursing home is different than working in a supermarket. When you're short-staffed, the cereal boxes don't know any better. Our business is human life and unfortunately, mandatory...
On admission, we SUGGEST to the doc our normal bowel protocol: 2 days no BM--warm prune juice 3 days no BM--30 ml MOM no BM in the following 16 hours--Fleet enema If we use MOM twice in a month, we...
dian57 replied to UM Review RN's topic in Geriatric, LTC
This is probably more than you're asking for but here goes . . . As with most problems, start at the beginning. WHY is this gentleman not eating? Look at his diagnoses and labs and see if they...
dian57 replied to Monica RN,BSN's topic in Geriatric, LTC
I sit at those budget meetings and believe me, they aren't pretty. When the directive comes down NO OVERTIME, what is actually meant is, No Unecessary Overtime. On review of my staff time sheets, the...